Proposed sequence of events leading to the development of chronic autoimmune diseases

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Description: English: In individuals with a genetic deficiency of CD8+ T cells (carried by “Autoimmune genes”) and with HLA class II genes predisposing to idiopathic dilated cardiomyopathy (HLA-DR4), primary biliary cirrhosis (HLA-DR8), and Crohn’s disease (HLA-DR7), primary EBV infection, particularly if delayed (Late), leads to the infection of autoreactive B cells, which accumulate in the target organ where they reactivate autoreactive T cells that orchestrate an autoimmune attack on the organ. For simplicity these depictions focus on the role of CD8+ T-cell deficiency, EBV infection and selected HLA alleles and do not include interactions with other genetic and environmental factors that may also contribute to the pathogenesis of autoimmune diseases. 日本語: （“自己免疫遺伝子”に因る）CD8+細胞傷害性T細胞の遺伝的な免疫不全と、突発性拡張型心筋症（idiopathic dilated cardiomyopathy）の素因となるHLA-DR4・原発性胆汁性肝硬変（primary biliary cirrhosis）の素因となるHLA-DR8・クローン病（Crohn’s disease）の素因となるHLA-DR7とが合わさって、自己応答性のB細胞はEBVの初感染（特にそれが遅れた）時にEBVに感染されることとなり、そのEBVに感染した自己応答性のB細胞は標的臓器に蓄積し、そこでその標的臓器への自己免疫応答を指揮する自己応答性のT細胞を再活性化させる。簡単のために、この絵ではCD8+細胞傷害性T細胞の機能不全・EBV感染・代表的なHLAアレルに焦点を当てており、自己免疫疾患の病態にまた関わるであろう他の遺伝的要因ないしは環境要因の相互作用については描かれていない。. Date: 24 January 2012. Source: Pender MP (2012). "CD8+ T-Cell Deficiency, Epstein-Barr Virus Infection, Vitamin D Deficiency, and Steps to Autoimmunity: A Unifying Hypothesis". Autoimmune Diseases. 2012: 189096., PMC: 3270541, PMID 22312480, doi: 10.1155/2012/189096. Author: Michael P. Pender.